Tu Shudan, Ying Huangfang, Ni Liyang, Zhang Zilong, Hu Weiping
Department of Ophthalmology, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, China.
Front Pediatr. 2025 Jun 3;13:1571790. doi: 10.3389/fped.2025.1571790. eCollection 2025.
This systematic review and meta-analysis aimed to compare outcomes of 0.01% atropine with orthokeratology (AOK) vs. orthokeratology (OK) alone for slowing the progression of myopia in children.
MEDLINE via PubMed, Embase, Scopus, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), Chinese electronic databases of VIP, and Wanfang were searched from inception until 19th August 2024 for randomized controlled trials (RCTs) about the review topic. The primary outcome was a change in axial length (AL) (mm). Secondary outcomes were spherical equivalent refraction (SER) (Diopter), pupil diameter (PD) (mm), amplitude of accommodation (AA) (Diopter), and intraocular pressure (IOP) (mmHg).
10 articles corresponding to eight RCTs were included. Meta-analysis found that change in AL was significantly reduced with AOK as compared to OK alone at 6 months (MD: -0.10 95% CI: -0.14, -0.06 I = 48%), 12 months (MD: -0.08 95% CI: -0.10, -0.07 I = 0%) and 24 months (MD: -0.14 95% CI: -0.19, -0.08 I = 0%). Pooled analysis found that AOK did not reduce the progression of SER (MD: 0.06 95% CI: -0.00, 0.12 I = 7%) and increased PD (MD: 0.63 95% CI: 0.40, 0.85 I = 86%) as compared to OK alone. Pooled analysis also found a tendency of reduced AA with AOK as compared to OK alone but without significant results (MD: -0.45 95% CI: -1.00, 0.10 I = 59%). Meta-analysis failed to show a statistically significant difference in change of IOP between AOK and OK (MD: -0.49 95% CI: -1.48, 0.50 I = 51%).
AOK seems to be more efficacious in slowing the progression of myopia in children as compared to OK alone.
本系统评价和荟萃分析旨在比较0.01%阿托品联合角膜塑形术（AOK）与单纯角膜塑形术（OK）延缓儿童近视进展的效果。
从创刊至2024年8月19日，检索MEDLINE via PubMed、Embase、Scopus、Web of Science、CENTRAL（Cochrane对照试验中心注册库）、中文电子数据库维普和万方，查找关于本综述主题的随机对照试验（RCT）。主要结局为眼轴长度（AL）（mm）的变化。次要结局包括等效球镜度（SER）（屈光度）、瞳孔直径（PD）（mm）、调节幅度（AA）（屈光度）和眼压（IOP）（mmHg）。
纳入了与8项RCT对应的10篇文章。荟萃分析发现，与单纯OK相比，AOK在6个月时（MD：-0.10，95%CI：-0.14，-0.06，I=48%）、12个月时（MD：-0.08，95%CI：-0.10，-0.07，I=0%）和24个月时（MD：-0.14，95%CI：-0.19，-0.08，I=0%）显著降低了AL的变化。汇总分析发现，与单纯OK相比，AOK并未降低SER的进展（MD：0.06，95%CI：-0.00，0.12，I=7%），且增加了PD（MD：0.63，95%CI：0.40，0.85，I=86%）。汇总分析还发现，与单纯OK相比，AOK有降低AA的趋势，但结果无统计学意义（MD：-0.45，95%CI：-1.00，0.10，I=59%）。荟萃分析未显示AOK与OK之间在IOP变化上有统计学显著差异（MD：-0.49，95%CI：-1.48，0.50，I=51%）。
与单纯OK相比，AOK在延缓儿童近视进展方面似乎更有效。
